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Advanced myocardial tissue characterisation by a multi-component CMR protocol in patients with rheumatoid arthritis

Simon Greulich1, Agnes Mayr2, Daniel Kitterer3

  • 1Division of Cardiology, Robert-Bosch-Medical Center Stuttgart, Stuttgart, Germany.

European Radiology
|May 14, 2017
PubMed

Insights

Rheumatoid arthritis patients show increased myocardial T1, extracellular volume (ECV), and T2 values compared to controls. Cardiovascular magnetic resonance (CMR) mapping aids in assessing cardiac involvement in rheumatoid arthritis.

Area of Science:

  • Cardiology
  • Radiology
  • Rheumatology

Background:

  • Rheumatoid arthritis (RA) patients face elevated risks of adverse cardiovascular events.
  • Cardiovascular magnetic resonance (CMR) mapping offers advanced myocardial tissue characterization.
  • Late gadolinium enhancement (LGE) is a standard CMR technique for assessing myocardial scarring.

Purpose of the Study:

  • To evaluate myocardial involvement in RA patients using a multicomponent CMR protocol.
  • To assess differences in myocardial tissue characteristics between RA patients and healthy controls.
  • To investigate the utility of CMR mapping techniques beyond LGE in RA.

Main Methods:

  • Prospective enrollment of 22 RA patients and 20 healthy volunteers.
  • Acquisition of CMR including LGE, T1 mapping, and T2 mapping sequences.
  • Comparison of myocardial parameters (native T1, ECV, T2 values) between groups.

Main Results:

  • RA patients exhibited significantly higher native T1, ECV, and T2 values compared to controls.
  • Elevated T2 values showed the most significant difference between RA patients and controls.
  • These findings were consistent irrespective of the presence of LGE.

Conclusions:

  • Advanced myocardial characterization using CMR mapping reveals subclinical myocardial changes in RA patients.
  • T2 mapping is particularly sensitive in detecting myocardial involvement in RA.
  • CMR mapping techniques, in addition to LGE, can enhance the evaluation of cardiac involvement in RA.
Abstract

Keywords:
Cardiovascular magnetic resonanceLate gadolinium enhancementMappingMyocardial involvementRheumatoid arthritis

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